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Airflow Obstruction and Use of Solid Fuels for Cooking or Heating: BOLD Results

Amaral AFS 1 , Patel J 2 , Kato BS 3 , Obaseki DO 4 , Lawin H 5 , Tan WC 6 Show all authors , Juvekar SK 7 , Harrabi I 8 , Studnicka M 9 , Wouters EFM 10 , Loh LC 11 , Bateman ED 12 , Mortimer K 13 , Buist AS 14 , Burney PGJ 15 , BOLD Collaborative Research Group

Affiliations 

  • 1 Imperial College London, NHLI - Respiratory Epidemiology, London, United Kingdom of Great Britain and Northern Ireland ; a.amaral@imperial.ac.uk
  • 2 Imperial College London, NHLI - Respiratory Epidemiology, London, United Kingdom of Great Britain and Northern Ireland ; j.patel@imperial.ac.uk
  • 3 Imperial College London, 4615, London, London, United Kingdom of Great Britain and Northern Ireland ; bkato@neriscience.com
  • 4 Obafemi Awolowo University, Medicine, Ile-Ife, Osun, Nigeria ; danseki@yahoo.com
  • 5 Unit of Teaching and Research in Occupational and Environmental Health, Faculty of Health Sciences, University of Abomey - Calavi , Cotonou, Benin, Cotonou, Benin ; hervelawin@gmail.com
  • 6 Univ British Columbia, icapture center, Vancouver, British Columbia, Canada ; wtan@mrl.ubc.ca
  • 7 Vadu Health and Demographic Surveillance System and Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India ; sanjay.juvekar@gmail.com
  • 8 Faculty of Medicine, Sousse, Tunisia, Sousse, Tunisia ; imed_harrabi@yahoo.fr
  • 9 Paracelsus Medical University, Pneumology, Salzburg, Austria ; m.studnicka@salk.at
  • 10 Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, Netherlands ; woutersemiel@gmail.com
  • 11 Penang Medical College, 26696, Georgetown, Pulau Pinang, Malaysia ; richard_loh@pmc.edu.my
  • 12 UCT Lung Institute, Cape Town, South Africa ; Eric.Bateman@uct.ac.za
  • 13 Liverpool School of Tropical Medicine, 9655, Liverpool, United Kingdom of Great Britain and Northern Ireland ; Kevin.Mortimer@liverpool.ac.uk
  • 14 Oregon Health Sciences University, Medicine / Pulmonary & Critical Care, Portland, Oregon, United States ; buists@ohsu.edu
  • 15 Imperial College, Respiratory Epidemiology and Public Health, London, United Kingdom of Great Britain and Northern Ireland ; p.burney@imperial.ac.uk
Am J Respir Crit Care Med, 2018 Mar 01;197(5):595-610.
PMID: 28895752 DOI: 10.1164/rccm.201701-0205OC

Abstract

RATIONALE: Evidence supporting the association of COPD or airflow obstruction with use of solid fuels is conflicting and inconsistent.

OBJECTIVE: To assess the association of airflow obstruction with self-reported use of solid fuels for cooking or heating.

METHODS: We analysed 18,554 adults from the BOLD study, who had provided acceptable post-bronchodilator spirometry measurements and information on use of solid fuels. The association of airflow obstruction with use of solid fuels for cooking or heating was assessed by sex, within each site, using regression analysis. Estimates were stratified by national income and meta-analysed. We carried out similar analyses for spirometric restriction, chronic cough and chronic phlegm.

MEASUREMENTS AND MAIN RESULTS: We found no association between airflow obstruction and use of solid fuels for cooking or heating (ORmen=1.20, 95%CI 0.94-1.53; ORwomen=0.88, 95%CI 0.67-1.15). This was true for low/middle and high income sites. Among never smokers there was also no evidence of an association of airflow obstruction with use of solid fuels (ORmen=1.00, 95%CI 0.57-1.76; ORwomen=1.00, 95%CI 0.76-1.32). Overall, we found no association of spirometric restriction, chronic cough or chronic phlegm with the use of solid fuels. However, we found that chronic phlegm was more likely to be reported among female never smokers and those who had been exposed for ≥20 years.

CONCLUSION: Airflow obstruction assessed from post-bronchodilator spirometry was not associated with use of solid fuels for cooking or heating.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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